Open AccessRenal transplant anastomotic pseudoaneurysms: Case report of open repair and endovascular management
Author(s) -
Sharma Nitin,
Bidnur Samir,
Caldas Mauricio,
McNally Dermot,
Murray Allan,
Turnbull Robert,
Todd Gerald T,
Moore Ronald B
Publication year - 2019
Publication title -
iju case reports
Language(s) - English
Resource type - Journals
ISSN - 2577-171X
DOI - 10.1002/iju5.12047
Subject(s) - medicine , pseudoaneurysm , surgery , anastomosis , angioplasty , external iliac artery , renal artery , stent , vascularity , radiology , aneurysm , kidney
Anastomotic pseudoaneurysm is one of the rarest vascular complications after renal transplant surgery. Therapeutic options include open surgical repair or endovascular stenting. Case presentation Case 1 had pseudoaneurysm involving external iliac artery and was managed by jump graft to allograft using cadaveric donor iliac arteries and patch angioplasty repair of external iliac artery after excising pseudoaneurysm. Case 2 had undergone orthotopic renal transplant with spleno‐renal arterial anastomosis and developed a massive pseudoaneurysm proximal to spleno‐renal arterial anastomosis. This patient underwent endovascular stenting preserving allograft vascularity and graft function. Outcome in both patients was successful with normalization of renal function to baseline levels. Conclusion Treatment of renal transplant anastomotic pseudoaneurysms is difficult and associated with high rates of graft loss. Open surgery is the gold standard providing several possibilities for arterial reconstruction preserving graft and limb circulation. Endovascular treatment should be considered in high‐risk surgical patients with favorable anatomy.